As if doctors don’t have enough pressure in their jobs, the pressures of for-profit businesses to turn physicians into, well, profit-making machines, is finally out in the open.
60 Minutes reporter Steve Croft interviewed three ER physicians (Jeff Hamby, Cliff Cloonan, and Scott Rankin) and a case manager (Nancy Alford) who were all former employees of Florida-based Health Management Associates (HMA), the fourth largest for-profit hospital company in the country. All four related stories of being rated on reports from a software company called ProMed Clinical Systems, which was used to rank physicians’ dollar performance, not quality of care. Those who didn’t meet what they were told was a minimum 20% threshhold of ER-to-inpatient admissions were first counseled and later fired, according to their accounts.
Several physicians are now suing Health Management Associates for wrongful termination. So is former HMA compliance director Paul Meyer, a former FBI employee, whose report to Gary Newsome, HMA’s president and CEO, cost him his job. Meyer is also suing.
Former HMA Executive Vice President Jon Vollmer, FACHE, fired from his position, was seen on an interview tape (a deposition?) saying that admissions quotas came from HMA upper-management, specifically Gary Newsom.
60 Minutes attempted to contact Newsome for his interview but was sent to Alan Levine, a senior vice-president and president for HMA’s Florida operation. Levine denied that the reports showing admissions goals of 20% from one Midwest hospital were anything he had seen or that were generated by HMA or on behalf of HMA. He characterized the four fired medical professionals as having their own motives, which was to promote their litigation against the firm and said that the documentation presented by HMA to 60 Minutes about the difficulties in managing patients between observation and inpatient admissions was not addressed.
Note: in November 1993, reporter Mike Wallace’s story on 60 Minutes on contracted ER services, in which he interviewed physician Jim Keeney, focused on quality-of-physicians issues. I recommend watching both of these reports for historical perspective.
On a personal note, I worked on similar profit-boosting issues when I was employed by American Medical International (AMI) back in the late 1980s! In my opinion, AMI was run into the ground by its C-suite executives’ focus on quarterly reports to please stockholders; it was a great study in short-term non-thinking that ruined a wonderful company filled with dedicated, hard-working medical professionals.
Monique Bryher, MSPH
Physician Real Estate Specialist
Physician Relocation Specialist